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Dan Kuai,1,2 Mengying Li,1,2 Ling He,1,2 Xiaoyan Li,1,2 Ying He,1,2 Shiqi Liu,1,2 Jiayu Wei,1,2 Xia Ji,3 Yingmei Wang,1,2 Wenyan Tian,1,2 Huiying Zhang1,2 1Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 2Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 3Baogang Hospital of Aerospace Medicine of Inner Mongolia, Baotou, 014000, People’s Republic of ChinaCorrespondence: Yingmei Wang, Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China, Email wangyingmei1978@126.com Huiying Zhang, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, No. 154, Anshan Road, He Ping District, Tianjin, 300052, People’s Republic of China, Tel +86-022-60362255, Email huiying_zhang2020@126.comAim: To assess body composition, glucolipid metabolism, and uric acid levels in PCOS (Polycystic Ovary Syndrome) patients to determine their relationship with the risk of endometrial hyperplasia (EH).Methods: A total of 232 patients were included and divided into groups according to whether they had PCOS and endometrial pathology (Group A: non-PCOS and normal endometrium; Group B: PCOS and normal endometrium; Group C: non-PCOS and EH; Group D: PCOS and EH). Body composition differences between groups and correlations between body composition, glucolipid metabolism, and uric acid levels were analyzed.Results: In Group D, the patient’s PSM (Percent Skeletal Muscle) of Trunk, PBF (Percent Body Fat) of Arm, free mass index, FMI (Fat Mass Index), and appendicular skeletal muscle mass index were significantly higher than in Groups A, B, and C. Waist-hip rate, PBF, PBF of Trunk, PSM of Leg, skeletal muscle mass index and visceral fat level were significantly higher than in Groups A and B. FMI was an independent risk factor for EH in PCOS patients, the AUC for FMI prediction of endometrial hyperplasia in PCOS patients was 0.82. FMI had significant positive correlations with fasting glucose, fasting insulin, HOMA-IR (Homeostatic Model Assessment for Insulin Resistance), total cholesterol, triglyceride, low-density lipoprotein, triglyceride/high-density lipoprotein, and uric acid levels. FMI was correlated with HOMA-IR and uric acid at 0.602 and 0.649 respectively in PCOS patients.Conclusion: Increased FMI and altered glucolipid metabolism as key factors associated with a higher risk of EH in patients with PCOS. Monitoring body composition and metabolic health in PCOS patients could help identify those at greater risk of EH, guiding preventive interventions.Keywords: polycystic ovary syndrome, endometrial hyperplasia, body composition, glycolipid metabolism, metabolic syndrome

Dan Kuai,1,2 Jiayu Wei,1,2 Mengying Li,1,2 Lu Chen,3 Dongcan Zhang,1,2 Xiaoyan Li,1,2 Ying He,1,2 Shiqi Liu,1,2 Huiying Zhang,1,2 Wenyan Tian,1,2 Yingmei Wang1,2 1Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 2Tianjin Key Laboratory of Female Reproductive Health and Eugenics, Tianjin Medical University General Hospital, Tianjin, 300052, People’s Republic of China; 3Department of Gynecology and Obstetrics, The First People’s Hospital of Datong City, Datong, Shanxi, 037000, People’s Republic of ChinaCorrespondence: Wenyan Tian; Yingmei Wang, Department of Gynecology and Obstetrics, Tianjin Medical University General Hospital, No. 154, Anshan Road, He Ping District, Tianjin, People’s Republic of China, 300052, Tel +86 60362277; 86-022-60362255, Email tianwenyan1108@163.com; wangyingmei1978@126.comObjective: To evaluate the therapeutic outcomes of weight loss and metformin use in patients with endometrial hyperplasia (EH), and to identify the factors influencing treatment efficacy.Methods: This study included data from patients diagnosed with either EH or endometrial atypical hyperplasia (EAH). Patients selected a progestin treatment regimen based on their diagnosis. Those with concurrent obesity or insulin resistance received additional weight management support and metformin therapy. Follow-up assessments were conducted every 3– 6 months.Results: A total of 202 patients were included. The metformin group exhibited significantly greater improvement in abnormal uterine bleeding (91.5% vs 57.1%, p < 0.001) and in ultrasound findings (91.5% vs 66.7%, p < 0.001) than the non-metformin group. Patients who achieved > 3% weight loss and those using metformin showed a significantly higher rate of disease reversal than those with ≤ 3% weight loss (91.2% vs 77.6%, p = 0.034) and the non-metformin group (93.2% vs 52.4%, p < 0.001). At follow-up durations exceeding 12 months, metformin use was associated with a significantly higher disease reversal rate (82.1% vs 42.9%, p = 0.048) and a lower recurrence rate (12.8% vs 28.6%, p = 0.048). Weight loss of > 3% (odds ratio: 0.041, 95% confidence interval: 0.004– 0.437, p = 0.008) and metformin use (odds ratio: 0.059, 95% confidence interval: 0.011– 0.311, p = 0.001) were both independently associated with improved reversal rates in patients with EH/EAH.Conclusion: Combining progestin therapy with weight loss and metformin is more effective in reversing EH than progestin alone. Regular metformin use, alongside weight loss, serves as a protective factor in EH management, with the protective effect of metformin increasing with longer use.Keywords: endometrial hyperplasia without atypia, comprehensive management, weight management, metformin

Abstract Iron-carbon micro-electrolysis system is a promising method for promoting electron transfer in nitrate removal. However, many traditional approaches involving simple physical mixing inevitably suffered from the confined iron-carbon contact area and short validity period, leading to the overuse of iron. Here, a ceramsite-loaded microscale zero-valent iron (mZVI) and acidified carbon (AC) coupled-galvanic cell (CMC) was designed to support chemical, autotrophic and heterotrophic denitrification. Long-term experiments were conducted to monitor the nitrogen removal performance of denitrification reactors filled with CMC and thus optimized the denitrification performance by improving fabrication parameters and various operating conditions. The denitrification contributions test showed that the chemical denitrification pathway contributed most to nitrate removal (57.3%), followed by autotrophic (24.6%) and heterotrophic denitrification pathways (18.1%). The microbial analysis confirmed the significant aggregation of related denitrifying bacteria in the reactors, while AC promoted the expression of relevant nitrogen metabolism genes because of accelerated uptake and utilization of iron complexes. Meanwhile, the electrochemical analysis revealed a significantly improved electron transfer capacity of AC compared to pristine carbon. Overall, our study demonstrated the application of a novel mZVI-AC coupled material for effective nitrate removal and revealed the potential impact of CMC in the multipathway denitrification process. Graphical Abstract

Continuous cropping obstacle (CCO) in tobacco is a prevalent and intractable issue and has not yet been effectively solved. Many researchers have favored exploring environmentally friendly and sustainable solutions to CCO (e.g, the application of (bio-) organic fertilizers). Therefore, to study the effects of functional organic fertilizers (FOFs) on tobacco CCO, we applied five types of fertilizers in a tobacco continuous cropping field with red soil (i.e., CF: tobacco-special chemical fertilizers; VOF: vermicompost-based FOF; HOF: humic acid-based FOF; WOF: wood biochar-based FOF; COF: compound FOF). The tobacco plant agronomic traits, leaf yield, economic value, and chemical quality (nicotine, total sugar, K2O, Cl contents, etc.) were evaluated via the continuous flow method. Meanwhile, we determined rhizosphere soil physicochemical properties, phenolic acids content, and bacterial community diversity by high-throughput sequencing. The results show that FOFs improved the tobacco plant agronomic traits, leaf yield (by 2.9–42.8%), value (by 1.2–47.4%), and chemical quality when compared with CF. More content of NH4+-N, available P, and available K were discovered in the rhizosphere soil in VOF, HOF, and WOF. The rhizosphere sinapic acid and total phenolic acids content declined in the FOF treatments (1.23–1.56 and 7.95–8.43 mg kg−1 dry soil, respectively) versus those in the CF treatment (2.01 and 10.10 mg kg−1 dry soil, respectively). Moreover, the rhizosphere bacterial community structure changed under FOF functions: the beneficial microbes Actinobacteria, Firmicutes, Streptomyces, and Bacillus increased, and the harmful microbes Acidobacteria and Gemmatimonadota decreased in abundance. There was a positive correlation between the tobacco leaf yield and soil NH4+-N, TC content, and the relative abundance of Proteobacteria and Actinobacteriota. In summary, the application of VOF and WOF is a modest, practical, and environmentally friendly strategy to alleviate tobacco CCO from the standpoint of recycling solid waste.

Continuous cropping obstacle (CCO) is a common phenomenon in agricultural production and extremely threatens the sustainable development of agriculture. To clarify the potential keystone factors causing tobacco (Nicotiana tabacum L.) CCO, tobacco plants, topsoil, and rhizosphere soil were sampled from the fields with no, slight, and severe tobacco disease in Dali and Yuxi of Yunnan province in China. The physicochemical properties of topsoil and rhizosphere soil, the phenolic acids (PAs) contents in rhizosphere soil, and elemental contents in topsoil, rhizosphere soil, and tobacco plants were analyzed. Microbial diversity in rhizosphere soil was determined by the metagenomic sequencing method. The results showed that soil pH, texture, cation exchange capacity, organic matter, TC, TN, and available K contents showed a significant difference (p < 0.05) in soil physicochemical properties. There was a deficiency of B, K, Mg, and Mn contents in soil and/or tobacco plants. The contents of PAs, especially syringic acid in rhizosphere soil, varied significantly among the three sampling groups (p < 0.05). Meanwhile, microbial communities and functional genes changed from beneficial to harmful, showing an intimate correlation with soil pH and syringic acid content. It can be concluded that tobacco CCO could be allocated to the imbalance of soil micro-ecology, which possessed a regional feature at the two sampling sites.

Root-knot nematode disease occurs frequently due to continuous monocropping and excessive water and nitrogen input. The disease degree and gall index are often used to evaluate the damage of root-knot disease. However, the weak correlation between these two indicators to tobacco leaf dry weight has often been reported. The objective of this study was to verify whether the use of the root-knot density (RKD)—the root-knot number per unit root weight or volume—as a new indicator could describe the damage of root-knot disease to tobacco growth and yield quantitatively. A total of 3000 tobacco plants from 60 independent plots were classified according to the damage symptom of leaves in situ. A total of 6 plants in each plot were selected and sampled to represent six damage levels in a total of 360 plants. The responding roots were taken out with a root auger. The dry weight of the leaves, stems, roots and root knots as well as the root volume, root-knot number and volume, disease degree, and gall index were determined for all 360 plants separately. Our results showed that: (1) the disease degree and gall index of the root-knot nematodes had a weak negative correlation with the tobacco leaf dry weight while the leaf dry weight and the dry weight, volume, and number of root knots were not correlated; (2) the root dry weight, volume, and length of roots with a diameter ≥2 mm were significantly positively correlated with the leaf dry weight; (3) the RKD of roots with a diameter ≥2 mm was significantly negatively correlated with the leaf dry weight; and (4) the dry weight of the leaves, stems, and roots decreased significantly with the increase in the average RKD of roots with a diameter ≥2 mm in the reclassified groups, which was significantly positively correlated with the average reclassified disease degree and gall index. Our results highlighted that the proposed RKD in this paper can be used to evaluate the damage degree of root-knot disease quantitatively as a new indicator in future research and the practical diagnosis of root-knot nematodes.

Black shank, caused by Phytophthora parasitica var. nicotianae, is a widespread and destructive disease of tobacco. Crop rotation is essential in controlling black shank. Here, we confirmed that rotating black shank-infested fields with rapeseed (Brassica napus) suppressed the incidence this disease. Further study demonstrated that rapeseed roots have a strong ability to attract zoospores and subsequently stop the swimming of zoospores into cystospores. Then, rapeseed roots secrete a series of antimicrobial compounds, including 2-butenoic acid, benzothiazole, 2-(methylthio)benzothiazole, 1-(4-ethylphenyl)-ethanone, and 4-methoxyindole, to inhibit the cystospore germination and mycelial growth of P. parasitica var. nicotianae. Thus, rapeseed rotated with tobacco suppresses tobacco black shank disease through the chemical weapons secreted by rapeseed roots.